Is it more than menopause?

Fatigue, weight gain, brain fog, hair loss and difficulty sleeping are all common symptoms of menopause. But these symptoms are similar to hypothyroidism, better known as underactive thyroid. So, is it menopause or something else? How can you tell?

In women, hypothyroidism tends to develop around the menopause years. It occurs when the thyroid – a butterfly-shaped gland in your neck that controls your body’s metabolism – doesn’t produce enough thyroid hormones.

As a result, your metabolism slows, which can lead to lethargy, memory problems, irregular menstrual periods, weight gain, depression, hair loss, constantly feeling cold, and a host of other symptoms, which also frequently occur in women during perimenopause and menopause.

So how do you determine if your symptoms are caused by ovarian hormonal changes, thyroid hormone changes or some other condition altogether?

• Weight gain: Is your weight gain being misinterpreted as hypothyroidism when it is really linked to the slowing metabolism that affects all of us as we age? Menopausal women often find they need to work out differently or more frequently to achieve the same results as in younger years.
• Sleep problems: If you’re having trouble sleeping, is it your thyroid? Or is it a normal part of your transition through midlife? A 2007 survey by the National Sleep Foundation found that nearly half of U.S. women at this stage of life – 46 percent of those ages 40 to 54, and 48 percent of those ages 55 to 64 – report sleep problems.
• Depression: Some women may be experiencing depression due to empty nest syndrome, the challenge of caring for aging parents, or other events common at this phase of life, but they don’t recognize the symptoms. Sleeplessness, tiredness, and a lack of interest in activities you once enjoyed are common to both depression and an underactive thyroid.

Finding a diagnosis

A blood test can be used to diagnose hypothyroidism. It can then be easily treated with supplemental thyroid hormone. A more difficult scenario is when the lab work comes back normal but the symptoms persist. So why not give thyroid supplements to every woman approaching or in menopause?

When supplemental thyroid hormones are used without the presence of hypothyroidism, it can “rev up” your metabolism to the point where it leads to hyperthyroidism – also known as an overactive thyroid. You may have more energy and lose weight faster for a short period of time, about six months. But after that, you are likely to experience a paradoxical effect, where your thyroid becomes overstimulated, making you feel worse again.

My recommendation? Work with a trusted resource who offers each woman an individualized, thorough approach to diagnosis and treatment. There is no “cookie cutter” approach.

Personalized care starts with a review of your current medical issues and symptoms, your medical history, other factors going on in your life, and baseline blood work. We then collaborate across gynecology, reproductive psychiatry, endocrinology and other experts in our multidisciplinary setting, as needed, to determine the most likely cause or causes of your symptoms. From there, we develop a long-term treatment plan to help get you back on track and keep you there.

–By Dr. Nina Ali, assistant professor of Obstetrics and Gynecology at Baylor College of Medicine